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The global financial crisis increased uncertainty in economic policy. Firms manage challenges through business strategies and financial constraints and deal with crash risk more proactively to overcome these impediments. This paper investigates the mediating role of financial constraints in the association between business strategy and crash risk, and the type of business strategy that influenced crash risk in Egyptian firms from 2014 to 2021. Data were obtained from financial statements and reports available in the Thomson Reuters database. A total of 792 observations were collected, representing 99 Egyptian firms. The statistical techniques employed in the analysis included ordinary least squares, modified least squares, and path analysis. The results indicate that a higher financial constraint ratio increases crash risk and has a mediating effect on business strategy and crash risk. Results show a positive impact of prospector strategy on crash risk using OLS and GLS, in line with the bad news hoarding hypothesis. Further research shows that prospector strategies have a positive effect on financial constraints. Egyptian firms have higher levels of information asymmetry, which leads to adopting a prospector business strategy and exerts a more pronounced positive influence on the likelihood of crash risk. A robustness check confirms the positive effect of financial constraints as a mediator variable on the relationship between prospector business strategy and crash risk.

The environment for enterprise external financing has deteriorated recently, especially in the wake of the COVID-19 outbreak, which has severely restricted enterprise external financing options. Therefore, it is essential to implement efficient financial methods to encourage business growth. This paper intends to investigate the moderating effect of board financial expertise on the relationship between flexibility and investment efficiency of listed companies in Egypt. This study includes moderator and control variables to produce an empirical model and findings that are more reliable based on 592 sample observations collected as annual secondary data from 2014 to 2021. Generalized least squares, logistic regression, and panel-corrected standard error were employed in the analysis. Results indicate that a higher board financial expert’s ratio decreases investment efficiency and has a moderating effect on financial flexibility and investment efficiency. High proportions of flexibility affect investment efficiency. Robustness checks confirm the negative effect of board financial expertise on the relationship between flexibility and investment efficiency. In unpredictable times, financial flexibility can help firms meet capital needs and boost the effectiveness of their investment decisions. Therefore, to increase investment efficiency and support firm growth, firms should maintain their financial flexibility while tightening internal controls.

Economic policy uncertainty intensified as a result of the global financial crisis. To overcome these obstacles, firms handle issues with financial distress and crash risk more proactively. This paper offers new insights into the relationship between financial distress and crash risk on the Egyptian stock market during the period of 2014–2021 and presents how managers strengthen the bad news hoarding mechanism to their advantage. Data were collected via financial statements and reports obtained from the Thomson Reuters database using 824 annual observations of 103 Egyptian firms via the generalized method of moments and ordinary least squares. Results show a strong positive impact of financial distress on crash risk using OLS and GMM. Results support the role of managerial opportunism to cover up bad news that undermines a firm’s economic fundamentals. The findings support an agency theory of how financial distress affects crash risk. The findings support conducting robust tests for alternative financial distress and crash risk measures.

Abstract We study flavor changing neutral current decays of B and K mesons in the dark U(1) D model, with the dark photon/dark Z mass between 10 MeV and 2 GeV. Although the model provides an improved fit (compared to the standard model) to the differential decay distributions of B → K (∗) ℓ + ℓ −, with ℓ = μ, e, and B s → ϕμ + μ − , the allowed parameter space is ruled out by measurements of atomic parity violation, K + → μ + + invisible decay, and B s − B ¯ s $$ {B}_s-{\overline{B}}_s $$ mixing, among others. To evade constraints from low energy data, we extend the model to allow for (1) additional invisible Z D decay, (2) a direct vector coupling of Z D to muons, and (3) a direct coupling of Z D to both muons and electrons, with the electron coupling fine-tuned to cancel the Z D coupling to electrons via mixing. We find that only the latter case survives all constraints.

Abstract Purpose Breast cancer is one of the most prevalent malignant diseases in women. The development of dose dense chemotherapy regimens has improved clinical outcomes but has been associated with increased hematological toxicity. Currently there is a paucity of data on the use of lipegfilgrastim in dose dense AC treatment in early breast cancer. The purpose of this study was to assess the use of lipegfilgrastim in the treatment of early breast cancer and to examine the incidence of treatment-related neutropenia during the dose dense AC phase and subsequent paclitaxel treatment. Methods This was a single arm, non-interventional, prospective study. The primary endpoint was to determine the rate of neutropenia defined as ANC of 38 °C and ANC

Steel pipe piles have been increasingly used as deep foundations for offshore or onshore structures in weak soil formations. These piles are usually open-ended and installed to their final level using suitable hammers or vibrators relying on the subsurface conditions. Simultaneously, the soil plug (SP) forms inside the employed pipe pile during driving or installation. Moreover, it affects bearing behavior and total pile resistance. The experimental tests have been performed on a single tube pile. All tube piles were tested using the well-graded sand collected from the Egyptian desert, and the sand was prepared at medium density using a raining technique. The outcomes of the model pile tests showed that the value of plug resistance in open-ended pipe pile (OEPP) is typically on the order of 50% to 70% of the total pile load of OEPP, and it is influenced by pile thickness, pile diameter, pile length, and submerged state. Simultaneously, the plugging influence of OEPP increased with increasing pile thickness and embedded pile length. However, the plugging influence decreased with increasing pile diameter. The total pile load of OEPP increased with increasing the embedded pile length. It must be noted that the influence of pile length on the total pile load is greater than the influence of pile diameter; this refers to the pile length having a significant effect on the total pile load. This is due to an increase in the influence of SP.

Geomembranes are one of the most widely used insulation materials in various civil engineering applications. Failure due to the slippage between geomembranes and the interfacing soils was detected at some cases. This paper presents the results of a series of laboratory tests carried out to investigate the factors controlling the developed interface stresses strength between the soil and geomembranes. In order to quantify the effect of different commonly used isolation membranes on the behavior and stability of buried concrete structures, laboratory studies by using modified direct shear apparatus is performed and integrated and the reduction in the shear resistance between the soil and different types of isolation geomembranes is determined. Graded sand with well-rounded particles was used in the experimental program. Shear tests were conducted under a normal stress range of about 25-100 kPa. The effect of the geomembranes on the peak and residual interface shear strengths is highlighted. Test’s results indicate development of peak interface shear resistance at a small strain and constant residual interface shear resistance at large strain. It was found that the developed peak and residual interface friction angles between the sand and the geomembranes interfaces ranged from 59 % to 82 % of the corresponding peak and residual interface friction angles between sand and un-protected concrete.

Using a novel dataset of foreign direct investment (FDI) corporations in the renewable electricity industry (REI), coupled with a large range of employed variables, this paper empirically examines FDI determinants in the REI in Africa between 2003 and 2019. The electricity insecurity issues worsen daily, aggravating all facets of African life. A range of promising and informative results were found using the FDI panel gravity fixed effects Poisson pseudo-maximum likelihood model. Interestingly, we reveal the uselessness of fossil fuel subsidy changes in stimulating green FDI in Africa. However, a 1% growth in Africa’s gross domestic product expands FDI by almost 1.5%. Similarly, one additional point in the corruption index reduces FDI by about 1.2%. Furthermore, increasing the number of educated African children and raising renewable energy awareness contributes constructively to the REI and sustainable energy development. To mitigate the energy issues, policymakers should elevate clean power consciousness among Africans and enhance sustainable energy support and policies.

This paper explores the impact of cash holdings on stock returns in small and medium enterprises. The sample includes 24 SMEs listed on the Egyptian Nile Exchange, excluding service firms, with a total of 96 observations from 2016 to 2019. Data was collected from financial statements and reports obtained through an information dissemination company in Egypt. This study uses a panel data analysis with comparing all results via ordinary least squares and the generalized method of moments. The findings show a statistically significant negative effect of cash holding on stock returns in small and medium enterprises on the Egyptian Nile Exchange. Further, the evidence shows that firms with higher levels of cash holding have higher investment alternatives and then lower stock returns. This result supports the agency theory that an increase in cash holding leads to managers exploiting cash resources to achieve personal benefits, thus increasing agency costs, lowering investment efficiency, and therefore lowering stock returns. The results support the trade-off between risk and return by using cash holding to finance operational activities and investing in higher investment alternatives and then lower stock returns.

Over the past two decades, most urban areas in different parts of the world have involved in many initiatives aimed to raise the level of infrastructure and urban services in order to develop its environmental, social and economic conditions and to enhance the attractiveness and competitiveness of urban areas. There is no doubt that contemporary rapid changes have affected the human use of buildings and outdoor spaces, therefore experts in the field of information and communication technology seek to work side by side with architects to develop modern methods and technologies to create urban environments that combine luxury and efficiency in the use of energy resources and the provision of information and services for users. Therefore, it is crucial that urban design can adapt to contemporary changes and current challenges in terms of overriding urbanization, encroachment on agricultural lands, climate change, desertification, and other urban problems. This study assumes that the establishment of sustainable smart urban communities varies from one region to another according to the balance between scarcity and the self-capacity of each region on one hand and the awareness of the local community and its ability to respond to smart urbanization on the other hand. This research paper aims to introduce a practical approach for activating the role of smart urban areas in the development of the proposed transverse axes of the proposed development and reconstruction corridor in the Western desert far from the narrow valley. The current research suggests a set of criteria and indicators related to the proposed urban projects in terms of their types and locations. The methodology is based on setting four scenarios for establishing smart urban communities on Kom Ombo - Aswan axis, which is one of the transversal axes of the proposed development and reconstruction corridor in the Western desert.

This work was motivated by studying the behavior of nanofluid adjacent to a moving vertical plate. A non-homogeneous distribution of nanoparticles inside the boundary layer was considered with variable Brownian and thermal diffusion coefficients throughout the layer. Employing group similarity transformation method transformed the governing mathematical model into a system of ordinary differential equations. The resultant system was numerically solved using shooting method. The numerical investigation was carried out for different parameters namely: Prandtl number, Pr, temperature difference ratio, Υ, and the ratio of nanoparticles volumetric fraction difference, Υφ, and the attained results were illustrated graphically to examine their effect on different fluid characteristics. The results showed that increasing Pr values decreased the nanofluid velocity, shear stress, temperature distribution and nanoparticles volumetric fraction, while it increased the heat flux and nanoparticles gradient inside the boundary layer. On the other hand, increasing Υ values increased the nanofluid velocity, shear stress and heat flux but it decreased the temperature distribution. Also, increasing Υφ values decreased the nanofluid velocity, shear stress and temperature distribution but it increased the heat flux. The characteristics of nanofluids were studied to enhance the thermal conductivity and the efficiency of heat transfer systems. A comparison between the obtained results and the previous published results indicated an excellent agreement.

Mona A Hegazy,1 Ibrahim Abd ALgwad,1 Soheir Abuel Fadl,1 Mohamed Sayed Hassan,1 Laila Ahmed Rashed,2 Maha A Hussein1 1Internal Medicine Department, Kasr Al-Aini Hospitals, Cairo University, Cairo, Egypt; 2Biochemistry Department, Kasr Al-Aini Hospitals, Cairo University, Cairo, EgyptCorrespondence: Mona A HegazyInternal Medicine Department, Kasr Al-Aini Hospitals, Cairo University, Cairo, EgyptEmail monahegazy@cu.edu.egBackground: Metabolic-associated fatty liver disease (MAFLD) is a common disease worldwide. Micro-RNA-122 is known to be the most abundant micro-RNA expressed in the liver.Objective: To evaluate the association of micro-RNA-122 and the degree of steatosis and fibrosis in obese patients with MAFLD.Methods: The study included 120 obese Egyptian patients with MAFLD, which were diagnosed and classified according to ultra-sonographic liver findings. All patients enrolled in the study were subjected to thorough clinical examination and laboratory investigations (serum micro-RNA-122 levels by PCR, lipid profile, liver biochemistry, and functions). Fibro-scan was used to assess the level of fibrosis.Results: There was a significant increase in levels of micro-RNA-122 in obese patients with MAFLD compared to controls (p< 0.001). Micro-RNA-122 level was lower in patients with mild liver steatosis than patients with moderate or severe steatosis (p< 0.001). It was lower in patients with a mild degree of fibrosis than those with mild or moderate fibrosis (p< 0.001). Micro-RNA-122 was significantly positively correlated with low-density cholesterol and triglycerides level, and liver enzymes, and negatively correlated to high-density cholesterol (p< 0.001).Conclusion: Serum micro-RNA-122 could be a useful predictor of assessing MAFLD severity regarding level of steatosis or fibrosis.Keywords: MAFLD, micro RNA, steatosis and fibrosis

Noha Adly Sadik,1 Laila Ahmed Rashed,2 Mai Ahmed Abd-El Mawla3 1Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Department of Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt; 3Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, EgyptCorrespondence: Noha Adly SadikDepartment of Internal Medicine, Faculty of Medicine, Cairo University, Dyar City, Middle Hill El Mokattam, Cairo, 11571, EgyptTel +201278444526Email noha_adly@yahoo.comBackground: “Micro RNAs and their target genes recently have been identified to play a crucial role in the molecular pathogenesis of post-stroke ischemic cellular injury, which elucidates their new role in ischemic stroke diagnosis and therapy”. Thus, we evaluated the relative serum expression of miR-155, an inflammatory micro RNA, and the mRNAs (JAK2/STAT3) in acute ischemic stroke patients and its associations with the inflammatory cytokine TNF-α and different stroke risk factors.Subjects and Methods: The relative expression of serum miR-155 and mRNAs (JAK2/STAT3) was assessed using RT-PCR, serum TNF-α was measured using ELIZA in 46 acute ischemic stroke patients and 50 control subjects. Receiver operating characteristic (ROC) curve was constructed to assess the specificity and sensitivity of circulating miR-155, JAK2/STAT3 as biomarkers for acute ischemic stroke.Results: Circulating miR-155, JAK2/STAT3 were significantly up-regulated among stroke patients (8.5, 2.9, 4.2 fold respectively, P< 0.001) with significant increase in TNF-α (263.8 ± 10.7 pg/mL, P < 0.001). MiR-155, JAK2/STAT3 were positively correlated with TNF-α. MiR-155, JAK2/STAT3 were significantly increased in stroke patients and associated with risk factors such as hypertension, carotid atherosclerosis, and atrial fibrillation. Our study revealed that miR-155 has diagnostic accuracy for acute ischemic stroke where AUC=0.9, (P< 0.001).Conclusion: The elevated expressions of circulating miR-155, JAK2/STAT3, and TNF-α in acute ischemic stroke patients could trigger post-stroke cellular inflammation. MiR-155 could be used as potential inflammatory biomarker for acute ischemic stroke. However, further clinical studies are still needed to determine the exact role of miRNAs and different signal transduction expressions in the stage of acute ischemic stroke.Keywords: ischemic stroke, miR-155, Janus kinases, signal transduction, post stroke ischemic injury

Abstract We investigate the sensitivity of electron-proton (ep) colliders for charged lepton flavor violation (cLFV) in an effective theory approach, considering a general effective Lagrangian for the conversion of an electron into a muon or a tau via the effective coupling to a neutral gauge boson or a neutral scalar field. For the photon, the Z boson and the Higgs particle of the Standard Model, we present the sensitivities of the LHeC for the coefficients of the effective operators, calculated from an analysis at the reconstructed level. As an example model where such flavor changing neutral current (FCNC) operators are generated at loop level, we consider the extension of the Standard Model by sterile neutrinos. We show that the LHeC could already probe the LFV conversion of an electron into a muon beyond the current experimental bounds, and could reach more than an order of magnitude higher sensitivity than the present limits for LFV conversion of an electron into a tau. We discuss that the high sensitivities are possible because the converted charged lepton is dominantly emitted in the backward direction, enabling an efficient separation of the signal from the background.

We show how, in the B−L extension of the SM (BLSM) with an Inverse Seesaw (IS) mechanism for neutrino mass generation, a light Z′ state with moderate couplings to SM objects, hence ‘dark’ in its nature, can be associated, in conjunction with light sterile neutrinos, to some present day data anomalies, such as the anomalous magnetic moment of the muon as well as a possible signal indicating the existence of sterile neutrinos in neutrino beam experiments.

Africa is still struggling to mitigate its electricity insecurity issues. This situation renders foreign direct investment in the renewable electricity industry (FDIREI) and renewable electricity production (REP) to become simultaneously important to Africa. Using a novel dataset of FDIREI, this paper examines the existence and nature of cointegration and causality nexuses among FDIREI, REP, and economic growth (GDP) in 32 African countries over 2003–2019. For methodological robustness purposes; GDP is added. By applying the panel vector autoregression model based-Granger causality test and a static panel data model, which are followed by robustness tests, more informative results are reported. Importantly, we find evidence of the growth hypothesis between REP and GDP, as a unidirectional Granger causality is seen from REP to GDP. Further, the neutrality hypothesis is confirmed among the remaining variables. This left us with the importance of REP in revitalizing African countries’ economic growth. All facets of REP thus should be enhanced.

Numerous problems occur during engine operation, such as start-up, lack of lubrication, and overheating, resulting in engine components’ wear, power loss, and fuel consumption. Nanomaterials dispersed in engine oil can play an important role in improving the tribological properties of oil lubricants. This study investigated the influence of multi-walled carbon nanotubes (MWCNTs) and aluminum oxide nanoparticles (Al2O3 NPs) as nano-additives for lubricants. Different engine oil samples were loaded with 0.5–2.0 wt% Al2O3 NPs and 0.5–1.0 wt% MWCNTs and compared with unmodified oil. The tribological performance of the nano lubricants was investigated using the four-ball test method. In addition, the wear scar in the engine was evaluated using 3D micrographs and scanning electron microscopy (SEM). The results of the sliding surfaces with hybrid MWCNTs/Al2O3 NPs showed better friction performance and wear resistance. The coefficient of friction (COF) and wear scar width were improved by 47.9% and 51.5%, respectively, compared with unmodified oil.

Nature is the First source of inspiration for the designer in product design process in search of unconventional techniques of formal and construction solutions, in additional computer knowledge is essential in product design, the use of computers has necessitated a new way of helping to develop new methods of design, it required the use of computers to find a new way to help and thus develop new ways of designing. The process of creating new forms of industrial products, especially those of irregular and complex nature, requires the designer to explore many alternatives and innovative design solutions and rely on non-traditional methods in designing the shape, Since nature is the source of inspiration and creativity for the designer, the parametric design was the entrance of the designer to inspire from nature in the design of the industrial product and an entrance to achieve creativity and innovation in the form of the product, It provides a modern tool that enabled the designer to deal with the forms, especially the complex one, which was impossible to recognize the structure or it's form, in addition to enhancing the designer's ability to explore the wider horizons of design and development of creativity and innovation. As a result of a large wave of systematic innovation and continuous research to develop the design process and to explore new ways of inspiration from nature, a new design style known as parametricism has emerged; this establishes the concept of parametric design. It is a style characterized by characteristics and formalities through the complexity and dynamics of its curved lines, for its various components and elements. The concepts and techniques of computing determine the characteristics of this new style Parametricism has been built to fill the space with organic forms as if they are fluid flowing and connected, forming a dynamic path within it gives a sense of continuity and the movement between forms and is an introduction to simulate nature in organic forms. It has shifted the focus of the designer of the form making like use of traditional methods of creativity such as paper and pen to find a form that relies on physical models and methods of computer creativity, which gives the results of mimicking nature. Instead of the principle of classicalism and modernity in design as a set of simple overlapping elements, parametric principles emphasize that the design involves the writing of dynamic forms as if they were musical compositions containing large numbers of elements such as natural forms that organized within interconnected and adaptive systems, Parametricism is the basis of parametric design, which aspires to make all elements of design variable and mutually adaptive to achieve the formal objectives of design.

While charged lepton flavor violation (cLFV) with taus is often expected to be largest in many extensions of the Standard Model (SM), it is currently much less constrained than cLFV with electrons and muons. We study the sensitivity of the LHeC to e-τ (and e-μ) conversion processes pe−→τ−+j (and pe−→μ−+j) mediated by a Z′ with flavor-violating couplings to charged leptons in the t-channel. Compared to current tests at the LHC, where cLFV decays of the Z′ (produced in the s-channel) are searched for, the LHeC has sensitivity to much higher Z′ masses, up to O(10) TeV. For cLFV with taus, we find that the LHeC sensitivity from the process pe−→τ−+j can exceed the current limits from collider and non-collider experiments in the whole considered Z′ mass range (above 500 GeV) by more than two orders of magnitude. In particular for extensions of the SM with a heavy Z′, where direct production at colliders is kinematically suppressed, e−τ conversion at LHeC provides an exciting new discovery channel for this type of new physics.

Abstract For a number of years, there has been a certain inconsistency among the measurements of the branching ratios and CP asymmetries of the four B → πK decays (B + → π+ K 0, B + → π0 K +, B d 0 → π − K +, B d 0 → π 0 K 0). In this paper, we re-examine this B → πK puzzle. We find that the key unknown parameter is |C ′ /T ′|, the ratio of color-suppressed and color-allowed tree amplitudes. If this ratio is large, |C ′ /T ′| = 0.5, the SM can explain the data. But if it is small, |C ′ /T ′| = 0.2, the SM cannot explain the B → πK puzzle —new physics (NP) is needed. The two types of NP that can contribute to B → πK at tree level are Z ′ bosons and diquarks. Z ′ models can explain the puzzle if the Z ′ couples to right-handed uū and/or dd¯ $$ d\overline{d} $$, with g R dd ≠ g R uu . Interestingly, half of the many Z ′ models proposed to explain the present anomalies in b → sμ + μ − decays have the required Z ′ couplings to uū and/or dd¯ $$ d\overline{d} $$. Such models could potentially explain both the b → sμ + μ − anomalies and the B → πK puzzle. The addition of a color sextet diquark that couples to ud can also explain the puzzle.

Abstract In a recent paper we studied the effect of new-physics operators with different Lorentz structures on the semileptonic Λ b → Λ c τ ν ¯ τ $$ {\Lambda}_b\to {\Lambda}_c\tau {\overline{\nu}}_{\tau } $$ decay. This decay is of interest in light of the R(D (*)) puzzle in the semileptonic B ¯ → D ∗ τ ν ¯ τ $$ \overline{B}\to {D}^{\left(\ast \right)}\tau {\overline{\nu}}_{\tau } $$ decays. In this work we add tensor operators to extend our previous results and consider both model-independent new physics (NP) and specific classes of models proposed to address the R(D (*)) puzzle. We show that a measurement of R Λ c = ℬ Λ b → Λ c τ ν ¯ τ / ℬ Λ b → Λ c ℓ ν ¯ ℓ $$ R\left({\Lambda}_c\right)=\mathrm{\mathcal{B}}\left[{\Lambda}_b\to {\Lambda}_c\tau {\overline{\nu}}_{\tau}\right]/\mathrm{\mathcal{B}}\left[{\Lambda}_b\to {\Lambda}_c\ell {\overline{\nu}}_{\ell}\right] $$ can strongly constrain the NP parameters of models discussed for the R(D (*)) puzzle. We use form factors from lattice QCD to calculate all Λ b → Λ c τ ν ¯ τ $$ {\Lambda}_b\to {\Lambda}_c\tau {\overline{\nu}}_{\tau } $$ observables. The Λ b → Λ c tensor form factors had not previously been determined in lattice QCD, and we present new lattice results for these form factors here.

The tribological properties of Lithium grease specimens with different concentrations of Al2O3 nanoparticles were investigated using a pin on disc apparatus under different sliding speeds and normal loads. Results showed that Al2O3 nanoparticles enhanced the tribological properties of lithium grease and reduced the COF and wear scar width by approximately 57.9% and 47.5% respectively.

Background. Takotsubo cardiomyopathy is associated with increased risk of ventricular arrhythmias, atrial fibrillation, and bradyarrhythmias. However, sinus node dysfunction is relatively infrequent in the setting of takotsubo cardiomyopathy. Case Report. We are reporting a case of a 73-year-old woman with a history of asymptomatic sinus bradycardia who developed sick sinus syndrome complicated by takotsubo cardiomyopathy. Conclusion. Acute symptomatic sick sinus syndrome in patients with preexisting silent sinus node dysfunction can trigger takotsubo cardiomyopathy. Understanding precipitating factors of takotsubo cardiomyopathy and identifying the patients at risk of life-threatening arrhythmia can help in refining risk stratification and therapy planning. Patients with sick sinus syndrome complicated by takotsubo cardiomyopathy may benefit from pacemaker implantation. However, evaluation on a case-by-case basis is mandatory.

AngioVac is a vacuum-based device approved in 2014 for percutaneous removal of undesirable materials from the intravascular system. Although numerous reports exist with regard to the use of the AngioVac device in aspiration of iliocaval, pulmonary, upper extremity, and right-sided heart chamber thrombi, very few data are present demonstrating its use in treatment of right-sided endocarditis. In this case report, we describe the novel device used in debulking a large right-sided tricuspid valve vegetation reducing the occurrence of septic embolisation and enhancing the efficacy of antibiotics in clearance of bloodstream infection. Further research is needed in larger RSIE patient populations to confirm the benefits and the potential of improved outcomes associated with the AngioVac device as well as identify its potential complications.

Drug induced myocardial infarction is a known entity with different forms of steroids linked to coronary artery disease (CAD) either through promoting its traditional risk factors, inducing coronary spasm, or by other unidentified mechanisms. Dexamethasone is known to promote an atherogenic and hypercoagulable state. We report a case of a 75-year-old woman who had ST elevation myocardial infarction (STEMI) associated with dexamethasone use just 4 days following an angiogram showing minor luminal irregularities.